Impact of weight gain on outcomes in type 2 diabetes

Ross, Stuart A.; Dzida, Grzegorz; Vora, Jiten; Khunti, Kamlesh; Kaiser, Marcel; Ligthelm, Robert J.

doi:10.1185/03007995.2011.585396

Cited by 79 publications

(65 citation statements)

References 62 publications

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“…We used a more comprehensive approach of subgrouping studies based on behavioural interventions such diet, exercise and lifestyle changes to better reflect the evidence in the current literature. In addition to a modest reduction observed for measures of adiposity such as weight in kilograms, BMI and waist circumference, our review also found associated reductions in intermediate physiological outcomes such as blood pressure and incidence of type 2 diabetes, which reinforces the findings of other systematic reviews 87,88,89 documenting reduction in the need for pharmacologic therapy for blood pressure and glycemic control as a potential clinical benefit of modest weight loss.…”

Section: Comparison With Other Studiessupporting

confidence: 84%

Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis

et al. 2014

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Section: Comparison With Other Studiessupporting

confidence: 84%

Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis

et al. 2014

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“…Patients were glycemic control, blood pressure, and lipid outcomes in patients with T2DM. [6][7][8][9] As a result, weight management has become increasingly important in patients with T2DM. [10][11][12] Because of the high costs of care and risk of complications that negatively impact quality of life, T2DM is often a top priority for population management within managed care organizations and for providers.…”

Section: Self-reported Adherencementioning

confidence: 99%

Impact of Adherence and Weight Loss on Glycemic Control in Patients with Type 2 Diabetes: Cohort Analyses of Integrated Medical Record, Pharmacy Claims, and Patient-Reported Data

McAdam‐Marx¹,

Bellows²,

Unni³

et al. 2014

JMCP

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BACKGROUND: Managed care organizations put great effort into managing the population of patients with type 2 diabetes mellitus (T2DM) because of the health and economic burden of this disease. In patients with T2DM, weight loss and glycemic control are primary treatment aims to help improve patient outcomes, but these goals are not easily achieved. While achieving these aims requires a multifaceted approach of drug therapy management and lifestyle modification, truly understanding the role of medication adherence in achieving these outcomes is important for both patient and population management. This study expands on existing evidence that weight loss is associated with improved glycemic control by examining the role of medication adherence in achieving these goals in a managed care setting. This study is unique in that these associations are evaluated using multiple sources of data, including medical records for treatment outcomes, pharmacy claims, and patient-reported data to assess medication adherence. These data sources represent those typically available to payers or providers.OBJECTIVE: To describe the relationships between medication and adherence, weight change, and glycemic control in patients with T2DM.METHODS: This historical cohort study included adult patients with T2DM in a large integrated health system and was based on electronic health record and pharmacy claims data from November 1, 2010, through October 31, 2011, as well as data from a self-reported adherence survey conducted in March 2012. Included patients received a diabetes medication from a therapeutic class not previously received, between November 1, 2010, and April 30, 2011 (index date), who had blood glucose (HbA1c) and weight values at index date and 6 months follow-up, participated in an adherence survey, and had ≥ 1 prescription claim for the index-date drug. Associations between the dual outcomes of weight loss (≥ 3%) and HbA1c control (< 7.0%), while controlling for medication adherence and other demographic, treatment, and clinical variables, were evaluated using structural equation models (SEM). Separate models adjusted for different measures of medication adherence-self-reported using the 5-item Medication Adherence Rating Scale (MARS-5) and a modified medication possession ratio (mMPR) from pharmacy claims data. RESULTS:The study included 166 patients with a mean age of 61.1 (standard deviation = 12.1) years; 56.0% were female. Medication adherence was high, with 72.2% adherent using MARS-5 and 77.1% using mMPR measures. The SEMs found that only self-reported medication adherence is associated with weight loss (MARS-5: OR = 1.70, 95% CI = 1.11-2.60), while both self-reported and claims-based medication adherence were associated with HbA1c < 7.0% (MARS-5: OR = 1.59, 95% CI = 1.09-2.34; mMPR: OR 2.71, 95% CI = 1.22-5.98). Further, weight loss is significantly associated with HbA1c < 7.0% (MARS-5: OR = 3.60, 95% CI = 2.39-5.46; mMPR: OR 2.99, 95% CI = 1.45-6.17).CONCLUSIONS: This study has provided additional evidence ...

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“…In most cases, T2DM is associated with overweight or obesity 4 so that weight management may be an essential factor when selecting an appropriate antidiabetic therapy in T2DM 54 . Except metformin, traditional pharmacotherapies for T2DM (insulin, sulfonylureas, glinides, glitazones) can further increase body weight, making management of overweight or obese patients with T2DM quite challenging 4,55 .…”

Section: Body Weightmentioning

confidence: 99%

Cardiovascular Effects of Dipeptidyl Peptidase-4 Inhibitors: From Risk Factors to Clinical Outcomes

Scheen

2013

Postgraduate Medicine

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Impact of weight gain on outcomes in type 2 diabetes

Abstract: Weight management should be an integral part of a T2DM treatment strategy that includes selecting oral antidiabetes medications and insulin products that are weight beneficial.

Cited by 79 publications

References 62 publications

Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis

Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis

Impact of Adherence and Weight Loss on Glycemic Control in Patients with Type 2 Diabetes: Cohort Analyses of Integrated Medical Record, Pharmacy Claims, and Patient-Reported Data

Cardiovascular Effects of Dipeptidyl Peptidase-4 Inhibitors: From Risk Factors to Clinical Outcomes

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